tbuckley/cabot-search huggingface dataset:
Abstract P640: Evaluating Feasibility and Acceptability of “My HeartHELP” Mobile Application for Promoting Heart-Healthy Lifestyle Behaviors
Authors: Jina Choo, Songwhi Noh, Yura Shin
Journal: Circulation (2023)

Introduction: Few health-promoting mobile applications (apps) have automated feedback text messages for individual behavioral outcomes achieved with self-monitoring of multiple lifestyle behaviors. One such app is “My HeartHELP” that was developed for general adult population to promote heart-healthy lifestyle behaviors. This app targets six heart-healthy lifestyle behaviors, such as physical activity, non-sedentary behaviors, healthy eating behaviors, non-smoking, no alcohol binge drinking, and self-assessment of body weight. It was designed with three essential technologies: 1) text messaging the users for information on cardiovascular health, 2) self-monitoring of six lifestyle behaviors, and 3) automated and personalized feedback text messaging to users for behavioral outcomes obtained from self-monitoring. Objective: We aimed to evaluate the feasibility and acceptability of the “My HeartHELP” app. Methods: The participants were 30 community residents, who had at least one criterion of metabolic syndrome. To evaluate the feasibility, we assessed the completion of participants’ self-monitoring of their lifestyle behaviors by requesting them to use the app every day for four weeks. To evaluate the acceptability, we assessed behavioral changes and satisfaction of the participants using self-administered questionnaires before and after four weeks of using the app, and by conducting one session of a focus group interview after four weeks. Results: The mean age of participants was 41.1 years. During four weeks, they accessed the app on average 1.8 times per day, and 95% of the participants adhered to more than 75% of “completion of daily self-monitoring of each lifestyle behavior.” These data met the criterion of more than 70% of the participants who adhered. Participants reported improved behavioral changes in moderate-intensity physical activity (p = .020), non-sedentary behavior (p = .003), fruit and vegetable intakes (p = .001), no sugar-sweetened beverage intake (p = .005), and less fast-food intake (p = .018). On a five-point Likert scale, participants reported the following mean scores, i.e., 4.0 for easiness, 3.6 for health benefits, 3.9 for convenience, and 3.8 for recommendation to others. Data obtained from the focus group interview reflected that automated and personalized feedback text messages motivated the participants to promote their healthy lifestyles, and they suggested modifying the app interface for entering food intakes. Conclusions: The study results showed that “My HeartHELP” is a feasible and acceptable mobile app to promote self-monitoring and motivation for heart-healthy lifestyle behaviors.
Abstract P507: Pre-Statistical Harmonization of Cognitive Measures Across Eight Population-Based NIH Cohorts in the Collaborative Cohort of Cohorts for COVID-19 Research (C4R)
Authors: A. Zarina Kraal, Evelyn Ramirez, Alice Gavarrete Olvera, Pallavi Balte, Emily M Briceno, Ryan T Demmer, Mitchell S Elkind, Hector M González, Alden L Gross, Susan R Heckbert, Virginia J Howard, Akshaya Krishnaswamy, Deborah A Levine, Thomas H Mosley, Elizabeth C Oelsner, Sudha Seshadri, Astrid Suchy-Dicey, Kristine Yaffe, Jennifer J Manly, Priya Palta
Journal: Circulation (2023)

Introduction: Long-term neurological consequences (eg, stroke, impaired cognition) have been linked to SARS-CoV-2 infection and severity. There are limited data from studies with racial, ethnic, socioeconomic, and geographic diversity. C4R is a prospective study of adults from 14 cohorts that aims to link pre-COVID phenotyping, including cognition (8 studies), to COVID related illness and sequelae. We aimed to conduct pre-statistical harmonization of cognitive tests administered in English and Spanish from 8 cohorts: ARIC, CARDIA, FHS, HCHS/SOL-INCA, MESA, NOMAS, REGARDS, and SHS (Table). Methods: We conducted extensive item-level review of administration, scoring, and coding procedures and score distributions for 84 tests administered in English (all studies) and Spanish (NOMAS, MESA, HCHS/SOL-INCA). Results: Orientation to time and 3-word registration and recall spanned all studies and both languages. Word list recall and verbal fluency (animal; letter) spanned 7 studies (Table). There was variability in the structure, content, administration, scoring, and data coding procedures for items across cohorts and between Spanish and English. Word lists varied by number of words (9-16) and learning trials (3-5). Animal naming varied by time (30 vs. 60 seconds), animal type (4-legged vs. any animal), and scoring (allowing mythical/imaginary animals). Letter fluency varied by whether both Spanish and English words were permitted. Other tests differed by version, study-specific adaptations, prompts/cues, and specificity of scoring rules across cohorts. Conclusions: Cognitive test harmonization requires detailed review of administration, scoring, coding, translation, and procedural differences. Accounting for this variability is essential to cognitive data interpretation. Our pre-statistical harmonization will inform data augmentation and formal harmonization to yield harmonized measures of cognition to clarify population-level differences in cognitive outcomes linked to SARS-CoV-2 infection.
Abstract MP02: Gut Microbiome Alteration and Structural Brain Features Among Healthy Japanese Men
Authors: Sabrina Ahmed, Yuichiro Yano, Zhang Hexun, Yukiko Okami, Nazar Mohd Zabadi Mohd Azahar, Keiko Kondo, Hisatomi Arima, Sayuki Torii, Mohammad Moniruzzaman, Aya Kadota, Akira Andoh, Akihiko Shiino, Kazuhiko Nozaki, Hirotsugu Ueshima, Katsuyuki Miura
Journal: Circulation (2023)

Introduction: Growing evidence supports the bidirectional brain-gut microbiome interaction that contributes to brain health. However, no prior study has assessed the association between gut microbiomes and structural brain features in a healthy general population. Hypothesis: We assess the hypothesis that the gut microbiome composition is associated with structural brain features in healthy humans. Methods: Healthy Japanese men (n=623) aged 40-79 years participated in the examination of the Shiga Epidemiological Study of Subclinical Atherosclerosis II (SESSA II) between 2010 and 2014. Gut microbiota composition including diversity was assessed using 16S rRNA sequencing with DNA extracted from stool samples, and brain volumes (i.e., total brain volume, white matter, gray matter, and hippocampus) and white matter lesion volume (WMLV, reflecting Cerebral small vessel disease) were quantified using brain magnetic resonance imaging (MRI). We performed principal coordinate analysis (PCoA), multivariable-adjusted linear regression models, and linear discriminant analysis (LDA) by measuring effect size (Lefse). Results: Higher alpha diversity was associated with lower brain volumes of gray matter, white matter, and hippocampus (FDR adjusted Q &lt;0.01). For beta diversity, weighted unifrac Bray-Curtis distances measured by PCoA showed lower and higher groups formed distinct clusters in white and gray matter volumes. Multivariable linear regression and LDA analysis suggested that higher amount of the genera Lachnospiraceae butyrate-producing bacteria were associated with greater gray and white matter volume (see Figure). Conclusions: In conclusion, the gut microbiome was associated with the brain gray and white matter structural alterations in healthy Japanese adult men. Persons with higher amount of Lachnospiraceae butyrate-producing bacteria had higher gray and white matter volumes compared to those with lower amount of the bacteria.
Abstract P415: Trends in Ultra-Processed Food Intake by Supplemental Nutrition Assistance Program Participation in the U.S.
Authors: Euridice Martinez Steele, Neha Khandpur, Alyssa Moran
Journal: Circulation (2023)

Introduction: The Supplemental Nutrition Assistance Program (SNAP) plays an important role in shaping the diet of low-income individuals and families. Trends in ultra-processed food intake (UPF) among SNAP participants and non-participants has not been studied. Hypothesis: Compared to non-participants, SNAP participants would have a higher UPF intake; purchases would be larger for foods from SNAP-eligible versus ineligible venues. Methods: Data from NHANES survey cycles 2003-2004 through 2017-2018 were used. Dietary recalls from individuals ≥1 year of age were categorized according to Nova classification. Venues from which individuals reported buying food were grouped as SNAP-eligible (ex. grocery/supermarkets, convenience stores) or SNAP-ineligible venues (ex. restaurant/cafeteria). SNAP participation status was self-reported and categorized as SNAP participants; income-eligible nonparticipants (no SNAP + family income ≤130% of federal poverty line, FPL); lower-income, ineligible non-participants (no SNAP + family income &gt;130% - ≤300% of FPL); higher-income ineligible non-participants (no SNAP + family income &gt;300% FPL). UPF (% of total daily kcal) across eight survey cycles was examined using multivariable linear regression, stratified by SNAP participation status. Heterogeneous trends across SNAP participation status were tested by Wald F models. Trends were examined for UPF purchased from different venues. Analyses were conducted in youths (ages 1-19) and adults (≥ 20), separately. Results: The sample included 54979 participants from 2003-2004 through 2017-2018. The % of energy from UPF increased over time in both youth (Δ 2018-2003 , 4.3%; 95% CI, 2.9% - 5.8%; P linear trend &lt; .001) and adults (Δ 2018-2003 , 2.5%; 95% CI, 0.2% - 4.9%; P linear trend = .002). There were no differences between SNAP participants, income-eligible non-participants, lower-income ineligible and higher-income non-participants. The mean contribution of UPF from SNAP-eligible venues decreased in both youth (Δ 2018-2003 , -2.6%; 95% CI, -6.1% - 0.9%; P linear trend = .001) and adults (Δ 2018-2003 , -2.3%; 95% CI, -5.0% - 0.8%; P cubic trend &lt; .001) with no differences by SNAP participation. UPF purchases from fast-food restaurants increased in youth (Δ 2018-2003 , 2.2%; 95% CI, -0.4% - 4.8%; P quadratic trend = .036) and adults (Δ 2018-2003 , 2.9%; 95% CI, 0.6% - 5.1%; P cubic trend = .007), while those from schools remained unchanged. There were no differences by SNAP participation status. Conclusions: Total UPF consumption increased between 2003-2004 and 2017-2018 and were seen among both participants of SNAP and among income-eligible and ineligible non-participants. UPF were increasingly sourced from SNAP ineligible venues. SNAP benefit allotments should account for secular changes in dietary patterns by enabling the purchase of healthier processed and prepared foods.
Abstract P405: Low Social Support Mediates the Effect of Marital Stress on 12-month Cardiac-Specific Quality of Life in Young Adults With Acute Myocardial Infarction
Authors: Cenjing Zhu, Rachel P Dreyer, Fan Li, Erica S Spatz, Cesar Caraballo, Shiwani Mahajan, Valeria Raparelli, Erica C Leifheit, Yuan Lu, Harlan M Krumholz, John Spertus, Gail DONOFRIO, Louise Pilote, Judith H Lichtman
Journal: Circulation (2023)

Background: Marital stress is associated with worse cardiac outcomes in young adults (≤55 years) with acute myocardial infarction (AMI), but whether psychosocial factors mediate this association remains largely unknown. We conducted a mediation analysis to investigate whether marital stress worsened quality of life (QoL) after AMI by increasing the likelihood of depression or low social support. Methods: There were 1,037 married/partnered AMI survivors aged 18-55 years enrolled in the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients) study (2008-2012) (67% women, mean age 47 years). Marital stress was measured by the Stockholm Marital Stress Scale at 1 month post-AMI; categorized as absent/moderate or severe. Depression (Patient Health Questionnaire-9 score ≥10), low social support (ENRICHD Social Support Instrument score ≤3 on ≥2 items and total score ≤18), and cardiac-specific QoL (Seattle Angina Questionnaire) were assessed at 1 year post-AMI. Natural direct and indirect effects of marital stress, depression, and low social support on QoL were estimated by causal mediation analysis with bias-corrected bootstrapped confidence intervals. Baseline QoL, sex, age, race, and socioeconomic factors (education, income, employment, and insurance status) were entered as covariates in all models. Results: There was a statistically significant direct effect from severe marital stress to lower 1-year cardiac-specific QoL after adjusting for covariates ( Figure ). Low social support and depression mediated 14.7% and 11.1% of the total relationship between marital stress and QoL, respectively; however, only the mediating effect through low social support was statistically significant. Conclusion: Marital stress was significantly associated with worse 1-year cardiac-specific QoL, and this effect was partially mediated by low social support. Interventions to decrease marital stress that also screen and provide resources for social support may help to improve AMI outcomes.
Abstract P657: Association Between Perceived Discrimination and Arterial Stiffness: A Scoping Review
Authors: Patricia Pagan Lassalle, Craig Patterson, Michelle L Meyer, Lee Stoner
Journal: Circulation (2023)

Introduction: The association of perceived discrimination (PD) and subclinical cardiovascular disease (CVD) risk has not been established, limiting our understanding of the importance of PD to CVD pathology. Purpose: With respect to PD and pulse wave velocity (PWV), a measure of arterial stiffness and subclinical CVD risk, this scoping review aimed to: (i) identify and synthesize the available research, and (ii) identify research gaps and make recommendations for future research. Hypothesis: We hypothesized that greater PD would be associated with greater (worse) PWV. Methods: All original research was eligible if it included adults (≥18 years) and co-measurement of PD and PWV. Electronic databases (PubMed, Embase, SPORTDiscuss, and CINALH+) were searched up to June 28 th , 2022. Results: We identified 419 articles, of which 58 were duplicates, and 355 were irrelevant. We reviewed the full text of six articles. Three articles evaluated the same cohort, so two were excluded to minimize confounding, and another for lacking a measure of PD. As summarized in Table 1, a total of three observational (one longitudinal) studies were identified from Brazil, the UK, and the US. In the UK and Brazil studies, PD was associated with greater (worse) PWV. The Brazil study also reported that Black and Brown adults had greater odds of high PWV (&gt;10 m/s) compared to the reference group and to those in the same racial/ethnic group without PD. For the US study, PD was significantly associated with PWV in non-Hispanic Black (NHB) females only. Conclusion: There was a trend of a positive association between PD and greater (worse) PWV. In the US, the positive association was evident only for NHB females, suggesting sex may impact the effect of PD on PWV. Future studies should focus on characterizing the effect of PD by sex and consider additional factors like intersectionality or coping mechanisms that may influence the association and predispose certain populations to added CVD risk.
Abstract P536: The Association Between Arterial Stiffness and Incident Chronic Kidney Disease in a Large Community Cohort: The Atherosclerosis in Communities (ARIC) Study
Authors: Zhiqi Yao, Junichi Ishigami, Esther Kim, Shoshana Ballew, Yingying Sang, Hirofumi Tanaka, Michelle Meyer, Josef Coresh, Kunihiro Matsushita
Journal: Circulation (2023)

Background: Arterial stiffness was cross-sectionally associated with the prevalence of chronic kidney disease (CKD). Whether arterial stiffness was prospectively associated with incident CKD is not well characterized. Methods: Among 3,777 participants (mean age 75 years old, 42.7% female, 21.3% Blacks) without prevalent CKD in ARIC study at visit 5 (2011 to 2013), we examined the association of six measures for arterial stiffness measurements, carotid-femoral pulse wave velocity (cfPWV), heart-ankle PWV (haPWV), brachial-ankle PWV (baPWV), heart-femoral PWV (hfPWV), femoral-ankle PWV (faPWV), heart-carotid PWV (hcPWV) with the risk of incident CKD (defined by &gt;25% decline to estimated glomerular filtration rate &lt;60 ml/min/1.73m 2 or hospitalization with CKD diagnosis) using Cox regression models to estimate hazard ratios (HRs). Each arterial stiffness parameter was stratified by quartiles. Results: During follow-up (median 6.6 years) through 2019, 590 had incident CKD (incidence rate 23.2 per 1000 person-years). In the demographically adjusted model, the highest quartile (Q4) of cfPWV, haPWV, baPWV, and hfPWV were significantly associated with an increased risk of incident CKD compared to the lowest (Q1) (HR, 1.70 [95%CI 1.31 to 2.22], 1.29 [95% CI 1.01 to 1.64], 1.51 [95% CI 1.16 to 1.97], and 1.36 [95% CI 1.05 to 1.76], respectively). Once the model was further adjusted for major clinical risk factors for CKD, the associations were modestly attenuated but remained significant for cfPWV and haPWV (HR in Q4 vs. Q1, 1.34 [95% CI 1.02 to 1.76] and 1.38 [95% CI 1.04 to 1.82]), but not for baPWV and hfPWV. Subgroup analyses showed the associations were consistent in subgroups by gender, race, age, hypertension, and diabetes. Conclusion: Arterial stiffness as measured by PWV was associated with a higher risk of incident CKD in older adults, especially cfPWV and haPWV. Our findings support the temporal relationship of subclinical arterial stiffness predating incident CKD in older adults.
Abstract P528: Acute Kidney Injury Increases Mortality in Patients With Upper Gastrointestinal Hemorrhage (UGIB) and Acute Coronary Syndrome: A Population Based Study
Authors: Yaser Khalid, Kirti Dasu, Rohan Umrani, Neethi Dasu, Trinava Roy, Bhavana Kadiyala
Journal: Circulation (2023)

Background: Upper GI Bleeding (UGIB) is a common emergency with a relatively high incidence in the general population. Acute Coronary Syndrome (ACS) is often overlooked in gastrointestinal bleeding as its symptoms and signs are often subtle. Purpose: This study aims to compare the outcomes of patients admitted for ACS with and without UGIB. Methods: Data were extracted from the National Inpatient Sample (NIS) 2016-2019 Database. The NIS was searched for hospitalizations for adult patients with ACS as the principal discharge diagnosis with and without UGIB as the secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders. STATA software was used for analysis. Results: Among 35,740 patients who had ACS, 463 (1.3%) patients had UGIB. The adjusted odds ratio (OR) for inpatient mortality for ACS with UGIB compared to those without UGIB was higher (OR 1.94, p&lt;0.0001), length of stay was 4.27 days longer (p&lt;0.0001), and total charges were $55,479 higher (p&lt;0.0001). The Independent positive predictors of increased mortality were: Acute kidney injury (AKI) (p&lt;0.0001). Independent positive predictors of LOS and total charges were the following: Coronary artery bypass graft surgery (CABG), Intra-aortic balloon pump (IABP) insertion, AKI (p&lt;0.0001) Conclusion: UGIB patients with ACS did have higher inpatient mortality. A positive predictor of mortality included the presence of concomitant AKI. Thus, the prevention of AKI Is of utmost importance. Further, larger studies are warranted to identify new risk factors as predictors of mortality and improve awareness of GI bleeding risk and decrease LOS.
Abstract P413: Prevalence and Significance of Poor R-Wave Progression on Electrocardiography
Authors: Alexis Parks, Mustafeez Ur Rahman, Mariam Riad, Nupur Shah, Nikky Bardia, Rajasekhar Mulyala, Maulikkumar Patel, Usman Sarwar, G. Mustafa Awan, Christopher Malozzi, Bassam A Omar
Journal: Circulation (2023)

Background: The QRS pattern on the electrocardiogram (ECG) has an expected progressively increasing amplitude of the R waves in the anterior leads. Poor R wave progression (low R wave amplitude of &lt; 3 mm in V3) is commonly reported, however its clinical significance is unknown. It may be related to underlying cardiac pathology, body habitus, metabolic abnormalities or ECG lead placement errors. Studying the prevalence and significance of these findings in different genders and races will also shed some light on their clinical utility and applicability. Our objective is to assess the epidemiology and clinical significance of “Poor or Abnormal R-Wave Progression” as reported on routine ECGs. Methods: A database of ECGs performed at the University of South Alabama Medical Center ECG database (Intellispace and/or Cerner) was downloaded and compiled into searchable PDF format. ECGs were searched for patients with “Abnormal or Poor R Wave Progression”. Available clinical data on patients with these ECG findings were analyzed and reported as absolute numbers and percentages. Results: The total number of ECG with “Poor R-Wave Progression” were 318. Out of these, 209 (66%) were females and 109 (34%) males; 209 (66%) were black, 105 (33%) were white and 4 (1%) other races. There were 143 (45%) black females, 65 (20%) white females, 66 (21%) black males and 40 (13%) white males. There were 234 (74%) patients &lt; 60 years of age while 85 (26%) were 60 years of age or older. There were 233 (73%) with hypertension. Only 198 (62%) had echocardiograms, with an average ejection fraction (EF) of 52%. Out of these 49 ((25%) had mild to moderate decrease in EF ( &gt; 30 - 50%) while 28 (14%) had severely decreased EF of 30% or less. There were 81 (41%) with wall motion abnormalities concerning for coronary disease, while 95 (48%) had diastolic dysfunction. Discussion: Poor R-wave progression is a commonly reported finding on ECG. It is more prevalent in females, which may be due to improper lead placement or chest size. However, its higher prevalence in blacks may be indicative of higher incidence of heart failure, coronary disease and hypertension. It is more frequent in younger patients who may be more obese, but also carry multiple risk factors for cardiac disease. Poor R wave progression showed strong correlation with any degree of heart failure and with wall motion abnormalities on echocardiogram concerning for coronary disease. Therefore this finding should trigger a diagnostic cascade with echocardiography and/or stress testing, depending on the clinical scenario, in order to identify potentially serious underlying cardiac pathology which may be amenable to therapy.